经皮房间隔穿刺射频消融儿童左侧旁道阵发性室上性心动过速(附16例报告)

Transseptal puncture in radiofrequency catheter ablation for paroxysmal supraventricular tachycardia due to left accessory pathway in children:A report of 16 cases

目的评价经皮房间隔穿刺(TSP)射频消融治疗儿童左侧旁道所致阵发性室上性心动过速(PSVT)的可行性和安全性。方法2018年1月至2022年6月青岛大学附属妇女儿童医院收治的16例左侧旁道PSVT患儿选择TSP实施三维标测下射频消融治疗。回顾性总结患儿年龄、性别、体重、TSP透视时间、辐射剂量、手术时间和并发症等临床资料。结果所有患儿均顺利完成TSP及射频消融手术。患儿年龄2~15岁,平均为(8.31±3.59)岁,体重17~77 kg,中位数为30.50 kg,TSP透视时间中位数为2.50 min,辐射剂量平均为(12.83±1.89)mGy/m2和手术时间平均为(116.50±40.64)min。术中及术后早期均未发生严重并发症。随访未见房间隔残余缺损、心律失常复发、瓣膜损伤等并发症。结论TSP可顺利完成儿童左侧旁道PSVT的消融治疗,临床效果好,操作安全可行,可在儿科患者中推广。

Objective To explore the feasibility and safety of transseptal puncture(TSP)in radiofrequency catheter ablation for children with paroxysmal supraventricular tachycardia(PSVT)caused by left accessory pathway(LAP).Methods From January 2018 to June 2022,16 cases of PSVT caused by LAP received TSP and radiofrequency catheter ablation with three-dimensional mapping system in Heart Center,Women and Children's Hospital,Qingdao University.The clinical data of age,gender,body weight,radiation exposure time,amount of radiation,operative time and complications were summarized.Results TSP and radiofrequency catheter ablation were successfully performed in all children.The age of the children ranged from 2 to 15 years old,with an average of(8.31±3.59)years old.The body weight of the children ranged from 17 to 77 kg,with a median of 30.50 kg.The median TSP fluoroscopy time of the children was 2.50 min.The mean radiation dose and the mean operation time of the children were(12.83±1.89)mGy/m2 and(116.50±40.64)min.No serious complications occurred.No long-term complications such as residual atrial septal defect,recurrence of arrhythmia or valve injury were found during follow-up.Conclusion The ablation of PSVT for children's left accessory pathway can be successfully completed by TSP,with good clinical effect.The operation is safe and feasible,and can be promoted in pediatric patients.